AB0676 DELAYS IN CARE SEEKING AND DIAGNOSIS IN SYSTEMIC LUPUS ERYTHEMATOSUS AND ITS IMPACT ON DISEASE ACTIVITY AND DAMAGE
Authors: G. Serna-Peña, D. P. Flores-Gutierrez, O. E. Alvarez-González, G. García-Arellano, J. A. Cardenas-de la Garza, A. G. Rodriguez Flores, M. F. Ortiz Nuño, I. D. J. Hernandez-Galarza, D. Á. Galarza-Delgado
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Systemic lupus erythematosus (SLE) is an autoimmune disease that presents with heterogeneous manifestations, some of which can delay access to specialized attention and according to the symptom, also lead to greater damage. (1) <h3>Objectives</h3> Compare initial symptoms/signs and disease damage or activity in patients with SLE with medical attention or diagnostic delays. <h3>Methods</h3> We performed a cross-sectional study in the lupus clinic in Hospital Universitario Dr. José Eleuterio González. Patients over 15 years old with an SLE diagnosis according to the EULAR/ACR 2019 criteria and a disease duration &gt; 1 year were included in this study. Data from current EULAR/ACR 2019 disease classification, SLE Disease Activity Index (SLEDAI), and SLICC Damage Index were collected from patient files. Delay was defined as ≥ 6 months to request medical assistance or disease diagnosis. The timeline studied was divided into time from symptom onset to first medical assessment, and time from first medical assessment to SLE diagnosis. We compared demographics and initial symptoms, SLEDAI, and SDI scores between groups with and without delays. <h3>Results</h3> Fifty-five patients were evaluated, 96.4% were female, mean age at diagnosis was 30.44 years +/- 12.484, and the mean disease duration was 7.25 years. The most frequent symptom in both groups was arthritis/arthralgia, followed by mucocutaneous manifestations (Table 1). Mean time for requesting medical assistance was 483.4 days +/- 959.741 and for diagnosis 91.67 days +/- 194.417. 41.98% had a delay in medical attention, 52.72% had a delay in diagnosis, and 60% (33) of all patients presented some type of delay ≥ 6 months. No statistical difference was found in SLEDAI score (mean of 2.424 +/- 3.699) (p=.740 or SLICC score (mean 0.57 +/- 0.902) (p=.587) between groups. In the group with a delay in diagnosis, the patients were older, and in the group without a delay in diagnosis lupus nephritis was more prevalent. <h3>Conclusion</h3> Two out of 3 patients report delay ≥ 6 months in seeking medical assistance and/or a definitive diagnosis, although no statistical difference was found in disease activity or damage scores. Younger age and renal involvement were related to a prompt diagnosis. <h3>References</h3> [1]Ozbek S, Sert M, Paydas S, Soy M. Delay in the diagnosis of SLE: the importance of arthritis/arthralgia as the initial symptom. Acta Med Okayama. 2003;57(4):187-190. doi:10.18926/AMO/32807 [2]Sanchez-Rodriguez A, Meade-Aguilar J, Yang J, Figueroa Parra G, Osei-Onomah S, Giblon R, Langenfeld H, Chamberlain A, Crowson C, Duarte-Garcia A. Delays in Access to Specialized Care and Diagnosis in Patients with Systemic Lupus Erythematosus [abstract]. Arthritis Rheumatol. 2022; 74 (suppl 9). https://acrabstracts.org/abstract/delays-in-access-to-specialized-care-and-diagnosis-in-patients-with-systemic-lupus-erythematosus/. Accessed December 9, 2022 <h3>Disclosure of Interests</h3> None declared